A fitting venue! Developments with the Royal College of Pathologists Geraldine Hartshorne geraldine.hartshorne@warwick.ac.uk

Why did ACE get involved with RCPath? promote high standards of practice in clinical embryology and to support the professional interests of embryologists working in the UK. Problem: how to ensure that senior clinical embryologists are recognised by: (1) their employers, (2) their peers in other scientific disciplines and (3) internationally

Mandate, ACE 1997 Go away and think about it! Recognition needed for embryologists at high level, but reflecting job of clinical embryologist Not agreed whether ‘every lab must have one’ Portfolio approach appropriate ie not MSc/University based Legal basis of accreditation to be considered Compatible with state registration Go away and think about it!

Timeline (1) Early 1990s - first approach from ACE to RCPath 1997 - Establishment of ACE Professional Development Committee Considered how to quantify and document senior status Considered possible accrediting bodies 1999 - Exploratory meetings with shortlisted accrediting bodies (RCPath, RCOG, ESHRE) 2002 - Consultation of ACE membership 2002 - Consultation of ACE honorary members

Timeline (2) May 2003 Feedback from consultation. Firm mandate to negotiate with RCPath Embryology reps coopted to Specialty Advisory Committee (SAC) Genetics (currently Ginny Bolton, Mike Hooper) Standing Committee for Clinical Science (SCCS) (currently Dave Morroll) April 2004 Negotiations concluded May 2004 Approval by College Council

What is the Royal College of Pathologists? The Royal College of Pathologists' mission is to promote excellence in the practice of pathology and to be responsible for maintaining standards through training, examinations and professional development. The Royal College of Pathologists is the competent and authoritative body for professional training and standards in the pathology specialties in the UK. Fellowship and Membership of the College are widely respected indicators of specialist status and evidence of a commitment to high professional standards in the science and practice of pathology.

Membership conferred by examination

Who are the Pathologists? Biochemistry Genetics Toxicology Histocompatibility Immunogenetics Haematology Histopathology Immunology Medical microbiology Cytopathology Neuropathology Forensic pathology Etc…. Proportion of medically qualified and scientifically qualified consultants varies across disciplines from 0% to 100%

Terms of agreement: Clinical embryologists become eligible for full membership of college and election to Council Able to take same roles as other disciplines (reps to CSSC and SAC formalised) Initially to work closely with SAC Genetics (renamed to Genetics and Embryology) until gain 30 members, then can form own SAC Grandfathering allowed through part I (2 yr window of opportunity) but not part 2 Eligibility for grandfathering (see later!) Exams to be set up in clinical embryology (as for other disciplines)

Timeline (3) 2004 - ACE and College agree the terms 2005-2006 - Preliminary discussions with College Examinations Officer re transitional arrangements and examinations structure 7 December 2006 – first grandfathered entrants examined (viva x 2) 15 March 2007 – first grandfathered entrants hopefully approved by council.

Structure of MRCPath exams TWO PARTS Eligibility. 1st or 2nd class hons degree (or others considered on individual basis) Part 1 (~3 years after beginning training) Part 2 (minimum ~2 years after part 1)

Part 1 aims to determine whether an individual has, at an early stage of training, successfully acquired a core body of knowledge that will underpin their ability to practise in their chosen specialty. …..Knowledge

Part 2 Medical: to provide quality assurance that a trainee who has successfully completed the curriculum and programme (including assessment through the Record of In-Training Assessment [RITA] process) is able to practise as an unsupervised specialist and be awarded a Certificate of Completion of Specialist Training (CCST) in the specialty. Non-medical: passing the MRCPath examination indicates they have reached a standard of unsupervised practice. …..Skills

Structure of MRCPath exams Part 1 Theory exam (2 x 3 hour paper: one short answer, one essay) (must pass theory before taking practical exam) Practical exam (1 x 3 hour paper, plus oral) Part 2 Written submission case histories PhD or MD during training Dissertation (practical topic agreed in advance) Portfolio of >6 published papers (must have submission accepted before oral) 1 hour searching oral interview prepared questions and free discussion (science, regulation, management)

PART 1 PART 2 Awarded ACE certificate Get trainee embryology job State Registration (4 years) Relevant BSc or equivalent ACE certificate 2+ years Further supervised experience Independent Practitioner doing CPD PART 1 PART 2 Do embryology Masters course Theory Practical & oral Written Oral

First RCPath Examiners Panel in Clinical Embryology Sue Avery, Mary Herbert, Greg Horne, Geraldine Hartshorne (Chair) We will facilitate Grandfathering past part I (via CV and interview) – UK only Establishing discipline-specific exams for part I Examination of part 2 submissions and interviews Maintenance of standards equivalent to other disciplines Aims: Establishment of a recognised ‘consultant level’ qualification Eventually available internationally

Grandparenting…. NB…GRANDPARENT THROUGH PART ONE ONLY To be eligible… ACE Diploma plus 5 years working as a clinical embryologist Or 6 years working as a clinical embryologist Part time pro rata

Grandparenting…. Evidence required… Academic certificates ACE Diploma (if you have one) Detailed CV Professional references Statement of practice (ie HOW YOU TRAINED, WHAT YOU DO) Interview No fee! NB, a grandparent application does not guarantee acceptance. ACE setting up advisory group to prescreen potential applicants to help avoid problems.

Grandparenting…. What the examiners look for… Basic theoretical knowledge Safe and legal in lab Know own limits Range/breadth/depth of practice Logical approach to problem solving Responsibility Presentation

Don’t miss out!! Grandparenting…. Window of opportunity = 2 years ONLY. Likely dates, submission deadlines between mid 2007 and mid 2009. Don’t miss out!!

Examinations Usually twice yearly opportunities First Part 1 theory exams, likely 2008 First Part 1 practical exams, hopeful 2008 First Part 2 oral exams, as required - further to passing part 1 successfully.

Fees Grandfathered part 1 Free Exam part 1 theory £370 Exam part 1 practical £370 Exam part 2 written and oral £405 Annual membership fees Fellow (Member of 8 yrs standing) £354 Member £279 Diplomate (after pt 1, before pt 2) £116

International applicants?….. RCPath generally not restricted by nationality or where training undertaken There are international centres where exams can be taken International applicants not accepted for grandparenting (with possible exception of Ireland – for discussion with the College) Exams oriented towards UK practice Robust overseas training programme and/or secondment to work in UK

Conclusions Opportunity to reach the highest levels and be recognised! Not (yet?) needed for career progression Watch for the opportunity to apply Get involved